Infant jaundice – Symptoms and causes

Overview

Infant jaundice is yellow discoloration of a newborn baby’s skin and eyes. Infant jaundice occurs because the baby’s blood contains an excess of bilirubin (bil-ih-ROO-bin), a yellow pigment of red blood cells.

Infant jaundice is a common condition, particularly in babies born before 38 weeks’ gestation (preterm babies) and some breast-fed babies. Infant jaundice usually occurs because a baby’s liver isn’t mature enough to get rid of bilirubin in the bloodstream. In some babies, an underlying disease may cause infant jaundice.

Most infants born between 35 weeks’ gestation and full term need no treatment for jaundice. Rarely, an unusually high blood level of bilirubin can place a newborn at risk of brain damage, particularly in the presence of certain risk factors for severe jaundice.

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Symptoms

Yellowing of the skin and the whites of the eyes — the main sign of infant jaundice — usually appears between the second and fourth day after birth.

To check for infant jaundice, press gently on your baby’s forehead or nose. If the skin looks yellow where you pressed, it’s likely your baby has mild jaundice. If your baby doesn’t have jaundice, the skin color should simply look slightly lighter than its normal color for a moment.

Examine your baby in good lighting conditions, preferably in natural daylight.

When to see a doctor

Most hospitals have a policy of examining babies for jaundice before discharge. The American Academy of Pediatrics recommends that newborns be examined for jaundice during routine medical checks and at least every eight to 12 hours while in the hospital.

Your baby should be examined for jaundice between the third and seventh day after birth, when bilirubin levels usually peak. If your baby is discharged earlier than 72 hours after birth, make a follow-up appointment to look for jaundice within two days of discharge.

The following signs or symptoms may indicate severe jaundice or complications from excess bilirubin. Call your doctor if:

• Your baby’s skin becomes more yellow
• The skin on your baby’s the abdomen, arms or legs looks yellow
• The whites of your baby’s eyes look yellow
• Your baby seems listless or sick or is difficult to awaken
• Your baby isn’t gaining weight or is feeding poorly
• Your baby makes high-pitched cries
• Your baby develops any other signs or symptoms that concern you

Causes

Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of “used” red blood cells.

Newborns produce more bilirubin than adults do because of greater production and faster breakdown of red blood cells in the first few days of life. Normally, the liver filters bilirubin from the bloodstream and releases it into the intestinal tract. A newborn’s immature liver often can’t remove bilirubin quickly enough, causing an excess of bilirubin. Jaundice due to these normal newborn conditions is called physiologic jaundice, and it typically appears on the second or third day of life.

Other causes

An underlying disorder may cause infant jaundice. In these cases, jaundice often appears much earlier or much later than does the more common form of infant jaundice. Diseases or conditions that can cause jaundice include:

• Internal bleeding (hemorrhage)
• An infection in your baby’s blood (sepsis)
• Other viral or bacterial infections
• An incompatibility between the mother’s blood and the baby’s blood
• A liver malfunction
• Biliary atresia, a condition in which the baby’s bile ducts are blocked or scarred
• An enzyme deficiency
• An abnormality of your baby’s red blood cells that causes them to break down rapidly

Risk factors

Major risk factors for jaundice, particularly severe jaundice that can cause complications, include:

• Premature birth. A baby born before 38 weeks of gestation may not be able to process bilirubin as quickly as full-term babies do. Premature babies also may feed less and have fewer bowel movements, resulting in less bilirubin eliminated through stool.
• Significant bruising during birth. Newborns who become bruised during delivery gets bruises from the delivery may have higher levels of bilirubin from the breakdown of more red blood cells.
• Blood type. If the mother’s blood type is different from her baby’s, the baby may have received antibodies through the placenta that cause abnormally rapid breakdown of red blood cells.
• Breast-feeding. Breast-fed babies, particularly those who have difficulty nursing or getting enough nutrition from breast-feeding, are at higher risk of jaundice. Dehydration or a low caloric intake may contribute to the onset of jaundice. However, because of the benefits of breast-feeding, experts still recommend it. It’s important to make sure your baby gets enough to eat and is adequately hydrated.
• Race. Studies show that babies of East Asian ancestry have an increased risk of developing jaundice.

Complications

High levels of bilirubin that cause severe jaundice can result in serious complications if not treated.

Acute bilirubin encephalopathy

Bilirubin is toxic to cells of the brain. If a baby has severe jaundice, there’s a risk of bilirubin passing into the brain, a condition called acute bilirubin encephalopathy. Prompt treatment may prevent significant lasting damage.

Signs of acute bilirubin encephalopathy in a baby with jaundice include:

• Listlessness
• Difficulty waking
• High-pitched crying
• Poor sucking or feeding
• Backward arching of the neck and body
• Fever

Kernicterus

Kernicterus is the syndrome that occurs if acute bilirubin encephalopathy causes permanent damage to the brain. Kernicterus may result in:

• Involuntary and uncontrolled movements (athetoid cerebral palsy)
• Permanent upward gaze
• Hearing loss
• Improper development of tooth enamel

Prevention

The best preventive of infant jaundice is adequate feeding. Breast-fed infants should have eight to 12 feedings a day for the first several days of life. Formula-fed infants usually should have 1 to 2 ounces (about 30 to 60 milliliters) of formula every two to three hours for the first week.

Why It’s Best Not to Worry If Your Baby Has Jaundice – Health Essentials from Cleveland Clinic

Seeing your baby have yellowish eyes and skin can easily send parents into panic mode, especially if you’ve never seen it before. 

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This yellow discoloration in a newborn is called jaundice, and it’s a common issue, says pediatric gastroenterologist Kadakkal Radhakrishnan, MD.

Jaundice is due to an elevated level of yellowish pigment in the blood called bilirubin that forms when the baby’s body breaks down excess red blood cells. Bilirubin is carried through the blood to the liver, where it’s tagged to a chemical and excreted into bile, the green pigment made by the liver. Then it moves out of the body as waste.

“When your new baby begins breathing after birth, the excess red blood cells your baby had while in the uterus are broken down,” explains Dr. Radhakrishnan. “This generates a higher level of bilirubin in all babies after birth.”

This higher load of bilirubin and the fact that many infant’s livers can’t get properly get rid of it cause newborns to have higher levels of it. Sometimes, premature birth or an underlying disorder may aggravate their jaundice.

Should parents panic?

While your first line of defense might be to worry about your baby’s jaundice, it’s normal for babies born at term to have at least some jaundice that affects their eyes and face. It shouldn’t cause any problems, though.

“It’s normal to worry at first, but keep in mind that it’s nothing to be concerned about,” says Dr. Radhakrishnan. “This is typically seen on the baby’s second or third day of life and is called physiological jaundice.”

Some breastfed babies may have more jaundice than babies who aren’t breastfed, but this shouldn’t be a reason to stop breastfeeding. If you have concerns about jaundice and questions related to breastfeeding, be sure to talk to your child’s doctor.

“If the jaundice is noticeable on the first day of your baby’s life or it affects the chest or abdomen, it’s a sign their level of bilirubin may be higher than normal,” he says. “In this case, your baby should be evaluated by their doctor.”

Beyond physiological jaundice

When the onset of jaundice occurs on the first day or if jaundice doesn’t quickly go away, the problem could be beyond physiologic jaundice. Other issues could include blood group incompatibility, infection in the bloodstream, certain viral infections, abnormalities of certain enzymes or the red cell membrane. 

If your baby’s jaundice sticks around longer than one week of their life, then problems related to the liver that affect the flow of bile to the intestine will have to be considered. Though these problems are not common, the most common among them is biliary atresia, a disorder that leads to blockage in the bile ducts, which are the tubes that drain bile from the liver to the intestine. Talk to your baby’s doctor if the jaundice is prolonged.

“Often, elevated bilirubin doesn’t lead to any major health problems,” says Dr. Radhakrishnan. “However, very high levels or inadequately treated elevated levels may cause brain damage and the risk is higher for premature babies. But before you worry, know that this is uncommon.”

Treating jaundice

Most often, physiologic jaundice does not require treatment and will improve on its own.

“If jaundice spreads to the chest, abdomen, if your baby’s skin color looks more yellow or if you are concerned regarding your babies feeding or excess sleepiness, a pediatrician will need to check your baby’s bilirubin level,” he says. “The decision to treat is based on the level of bilirubin and the age of your baby. This decision should be made with the help of your child’s doctor.”

Placing the baby under light, called phototherapy, is the most common treatment to lower bilirubin levels – if the pediatrician considers it high enough to be treated. Phototherapy often requires hospitalization and a premature baby may need a more aggressive treatment than a full-term baby. .” “Although it’s rare, when severe jaundice doesn’t respond to other types of therapy, an exchange transfusion may be required,” says Dr. Radhakrishnan. “In this procedure, the baby’s blood is exchanged in small volumes, which dilutes the bilirubin and maternal antibodies. This requires close monitoring and needs to be done in a neonatal intensive care unit.”

“Occasionally, a jaundice vest, which is a portable phototherapy device, may be used for your baby’s bilirubin levels that are elevated but not considered high enough for hospitalization,” he says. “If the pediatrician approves, this blanket can be used at home while monitoring your baby’s bilirubin level.

Watch your baby’s eating

Whether your newborn has physiological jaundice or requires more intensive treatment, it’s important your baby is eating well. When your baby eats well, it can help them have good bowel movements and makes sure bilirubin gets excreted through their intestine. For this reason, your doctor may advise supplementary feeding beyond breastfeeding.

Newborn jaundice – NHS

Jaundice is a common and usually harmless condition in newborn babies that causes yellowing of the skin and the whites of the eyes. The medical term for jaundice in babies is neonatal jaundice.

Other symptoms of newborn jaundice can include:

• yellowing of the palms of the hands or soles of the feet
• dark, yellow urine (a newborn baby’s urine should be colourless)
• pale-coloured poo (it should be yellow or orange)

The symptoms of newborn jaundice usually develop 2 to 3 days after the birth and tend to get better without treatment by the time the baby is about 2 weeks old.

Find out more about the symptoms of jaundice in babies

Yellowing of the skin in newborn jaundice.

Credit:

When to get medical advice

Your baby will be examined for signs of jaundice within 72 hours of being born as part of the newborn physical examination.

If your baby develops signs of jaundice after this time, speak to your midwife, health visitor or a GP as soon as possible for advice.

While jaundice is not usually a cause for concern, it’s important to determine whether your baby needs treatment.

If you’re monitoring your baby’s jaundice at home, it’s also important to contact your midwife straight away if your baby’s symptoms quickly get worse or they become very reluctant to feed.

Find out more about diagnosing jaundice in babies

Why does my baby have jaundice?

Jaundice is caused by the build-up of bilirubin in the blood. Bilirubin is a yellow substance produced when red blood cells, which carry oxygen around the body, are broken down.

Jaundice is common in newborn babies because babies have a high number of red blood cells in their blood, which are broken down and replaced frequently.

Also, a newborn baby’s liver is not fully developed, so it’s less effective at removing the bilirubin from the blood.

By the time a baby is about 2 weeks old, their liver is more effective at processing bilirubin, so jaundice often corrects itself by this age without causing any harm.

In a small number of cases, jaundice can be the sign of an underlying health condition. This is often the case if jaundice develops shortly after birth (within the first 24 hours).

How common is newborn jaundice?

Jaundice is 1 of the most common conditions that can affect newborn babies.

It’s estimated 6 out of every 10 babies develop jaundice, including 8 out of 10 babies born prematurely before the 37th week of pregnancy.

But only around 1 in 20 babies has a blood bilirubin level high enough to need treatment.

For reasons that are unclear, breastfeeding increases a baby’s risk of developing jaundice, which can often persist for a month or longer. 

But in most cases, the benefits of breastfeeding far outweigh any risks associated with jaundice.

Treating newborn jaundice

Treatment for newborn jaundice is not usually needed because the symptoms normally pass within 10 to 14 days, although they can occasionally last longer.

Treatment is usually only recommended if tests show very high levels of bilirubin in a baby’s blood.

This is because there’s a small risk the bilirubin could pass into the brain and cause brain damage.

There are 2 main treatments that can be carried out in hospital to quickly reduce your baby’s bilirubin levels.

These are:

• phototherapy – a special type of light shines on the skin, which alters the bilirubin into a form that can be more easily broken down by the liver
• an exchange transfusion – where your baby’s blood is removed using a thin tube (catheter) placed in their blood vessels and replaced with blood from a matching donor; most babies respond well to treatment and can leave hospital after a few days

Complications

If a baby with very high levels of bilirubin is not treated, there’s a risk they could develop permanent brain damage. This is known as kernicterus.

Kernicterus is very rare in the UK, affecting less than 1 in every 100,000 babies born. There were 7 hospital admissions for kernicterus in England in 2015-16.

Find out more about kernicterus in babies

You can also read the National Institute for Health and Care Excellence (NICE) guidance about jaundice in newborn babies under 28 days.

Page last reviewed: 04 September 2018
Next review due: 04 September 2021

Newborn jaundice – Causes – NHS

Jaundice is caused by too much bilirubin in the blood. This is known as hyperbilirubinaemia.

Bilirubin is a yellow substance produced when red blood cells, which carry oxygen around the body, are broken down.

The bilirubin travels in the bloodstream to the liver. The liver changes the form of the bilirubin so it can be passed out of the body in poo.

But if there’s too much bilirubin in the blood or the liver can’t get rid of it, the excess bilirubin causes jaundice.

Jaundice in babies

Jaundice is common in newborn babies because babies have a high number of red blood cells in their blood, which are broken down and replaced frequently.

A newborn baby’s liver isn’t fully developed, so it’s less effective at processing the bilirubin and removing it from the blood.

This means the level of bilirubin in babies can be about twice as high as in adults.

By the time a baby is around 2 weeks old, they’re producing less bilirubin and their liver is more effective at removing it from the body.

This means the jaundice often corrects itself by this point without causing any harm.

Breastfeeding

Breastfeeding your baby can increase their chances of developing jaundice.

But there’s no need to stop breastfeeding your baby if they have jaundice as the symptoms normally pass in a few weeks.

The benefits of breastfeeding outweigh any potential risks associated with the condition.

If your baby needs to be treated for jaundice, he or she may need extra fluids and more frequent feeds during treatment.

See treating newborn jaundice for more information.

It’s unclear why breastfed babies are more likely to develop jaundice, but a number of theories have been suggested.

For example, it may be that breast milk contains certain substances that reduce the ability of the liver to process bilirubin.

Newborn jaundice thought to be linked to breastfeeding is sometimes called breast milk jaundice.

Underlying health conditions

Sometimes jaundice may be caused by another health problem. This is known as pathological jaundice.

Some causes of pathological jaundice include:

• an underactive thyroid gland (hypothyroidism) (where the thyroid gland doesn’t produce enough hormones)
• blood group incompatibility (when the mother and baby have different blood types, which are mixed during the pregnancy or the birth)
• rhesus factor disease (a condition that can occur if the mother has rhesus-negative blood and the baby has rhesus-positive blood)
• a urinary tract infection
• Crigler-Najjar syndrome (an inherited condition that affects the enzyme responsible for processing bilirubin)
• a blockage or problem in the bile ducts and gallbladder (the gallbladder stores bile, which is transported by the bile ducts to the gut)

An inherited enzyme deficiency known as glucose 6 phosphate dehydrogenase (G6PD) could also lead to jaundice or kernicterus.

It’s important to let your midwife, GP or paediatrician know if you have a family history of G6PD. Your baby’s jaundice symptoms will need to be closely monitored.

Page last reviewed: 01 August 2019
Next review due: 01 August 2019

Jaundice in babies | Pregnancy Birth and Baby

Jaundice is a common condition in newborns that causes yellowing of the skin and the whites of the eyes. Mild jaundice occurs in about 60% of full-term newborn babies, and in up to 80% of premature babies. You’re most likely to notice it from the third day after birth. Jaundice is usually harmless and disappears after 1 to 2 weeks.

Common causes of jaundice in newborns

When red blood cells break down, a chemical called ‘bilirubin’ is released, which makes the skin go yellow. Newborn babies are born with (and need to break down) a lot of red blood cells, but their liver isn’t developed enough to get rid of the bilirubin. This results in a bilirubin overload, which leads to jaundice. By about 2 weeks old, a baby’s liver is more developed and better at removing bilirubin from the blood.

Most newborns with jaundice will have ‘breast milk jaundice’. This is when a chemical in the mother’s breast milk interferes with the removal of bilirubin. This type of jaundice usually sorts itself out without treatment, after several weeks.

Rare causes of jaundice in newborns

One rare type of jaundice occurs when the mother’s and the baby’s blood groups are incompatible (usually ABO or Rhesus factor incompatibility). This isn’t usually a problem during a first pregnancy because the mother’s and the baby’s bloodstreams don’t mix. But during the birth, some of the baby’s blood might mix with the mother’s blood.

The mother then develops antibodies that become active during the next pregnancy and cross the placenta to attack a second baby’s red blood cells. The destruction of the red blood cells causes more bilirubin to be released into the second baby’s bloodstream, leading to jaundice. This type of jaundice is usually seen in the first 24 hours after birth.

Biliary atresia is another rare cause of jaundice in babies. It happens when the tiny tubes that carry bile from the liver to the intestine get scarred. Babies with this condition usually grow normally and look well at first, but they will get very ill with serious liver disease if they aren’t diagnosed and treated early. Their jaundice will usually go on after they are 2 weeks of age, and they might also have pale-looking poo.

Symptoms of jaundice

Jaundice in a newborn causes the skin and the whites of the eyes to go a yellow colour. It typically starts on the face and head. If the level of bilirubin increases, the colour will spread to the body. Babies might also be drowsy and have difficulty feeding.

When to see your doctor

Jaundice is usually harmless, but a nurse or doctor should check and monitor all cases of jaundice in newborn babies. Some babies have severe jaundice, which very occasionally can lead to deafness and even brain damage if not treated promptly.

You should take your baby to the doctor if:

• your baby is unwell, feeding poorly and not gaining enough weight
• your baby’s poo becomes pale or their wee becomes dark
• your baby develops jaundice in the first 48 hours after birth
• the jaundice becomes more noticeable after a week
• the jaundice hasn’t gone away after 2 weeks

Tests for jaundice

If your baby has jaundice lasting more than 2 weeks — especially if their poos are pale or their wees are dark — they’ll need a blood test to check the ‘conjugated bilirubin’ levels in the blood. They might then need more tests on their liver.

Treating normal jaundice

Treatment for jaundice in newborns depends on how bad it is and what has caused it.

Babies who develop jaundice several days after birth usually just need careful monitoring, sometimes with heel prick blood tests, to check the bilirubin levels in their blood. The treatment is simple — they just need to have enough fluids. If your baby has mild jaundice ensure they are breast or formula fed regularly.

If the bilirubin levels are high, the baby might have phototherapy treatment for a few days. This treatment uses ultraviolet light to help to break down the bilirubin overload. It involves the baby being placed naked in a cot under a blue phototherapy lamp for 2 to 3 days. The baby’s eyes will be covered for protection.

Phototherapy has minimal side effects, although the baby might have a mild rash and runny poo for a few days. Some babies have small fluid losses during phototherapy, so they might need extra feeds at this time. Most babies tolerate phototherapy treatment well.

If your baby has breast milk jaundice, you do not need to stop breastfeeding. This type of jaundice is usually mild and should get better by itself with time. Talk to your child and family health nurse or doctor if you’re worried about what to do.

Treating serious jaundice

Severe jaundice, in which bilirubin levels are very high, might need treatment with an exchange blood transfusion. This is when a baby’s own blood is replaced with compatible fresh blood. This isn’t common.

Prevention

Only ‘incompatible blood type’ jaundice is preventable. If this type of jaundice is suspected, the mother will receive an anti-D injection after the birth. This can prevent complications in subsequent pregnancies.

What are Jaundice and Kernicterus?

Jaundice is the yellow color seen in the skin of many newborns. Jaundice happens when a chemical called bilirubin builds up in the baby’s blood. During pregnancy, the mother’s liver removes bilirubin for the baby, but after birth the baby’s liver must remove the bilirubin. In some babies, the liver might not be developed enough to efficiently get rid of bilirubin. When too much bilirubin builds up in a new baby’s body, the skin and whites of the eyes might look yellow. This yellow coloring is called jaundice.

When severe jaundice goes untreated for too long, it can cause a condition called kernicterus. Kernicterus is a type of brain damage that can result from high levels of bilirubin in a baby’s blood. It can cause athetoid cerebral palsy and hearing loss. Kernicterus also causes problems with vision and teeth and sometimes can cause intellectual disabilities. Early detection and management of jaundice can prevent kernicterus.

Signs and Symptoms

Jaundice usually appears first on the face and then moves to the chest, belly, arms, and legs as bilirubin levels get higher. The whites of the eyes can also look yellow. Jaundice can be harder to see in babies with darker skin color. The baby’s doctor or nurse can test how much bilirubin is in the baby’s blood.

See your baby’s doctor the same day if your baby:

• Is very yellow or orange (skin color changes start from the head and spread to the toes).
• Is hard to wake up or will not sleep at all.
• Is not breastfeeding or sucking from a bottle well.
• Is very fussy.
• Does not have enough wet or dirty diapers (at least 4-6 thoroughly wet diapers in 24 hours and 3 to 4 stools per day by the fourth day).

Get emergency medical help if your baby:

• Is crying inconsolably or with a high pitch.
• Is arched like a bow (the head or neck and heels are bent backward and the body forward).
• Has a stiff, limp, or floppy body.
• Has strange eye movements.

Diagnosis

At a minimum, babies should be checked for jaundice every 8 to 12 hours in the first 48 hours of life. It is important for your baby to be seen by a nurse or doctor when the baby is between 3 and 5 days old, because this is usually when a baby’s bilirubin level is highest. This is why, if your baby is discharged before age 72 hours, your baby should be seen within 2 days of discharge. The timing of this visit may vary depending on your baby’s age when released from the hospital and other factors.

A doctor or nurse may check the baby’s bilirubin using a light meter that is placed on the baby’s head. This results in a transcutaneous bilirubin (TcB) level. If it is high, a blood test will likely be ordered.

The best way to accurately measure bilirubin is with a small blood sample from the baby’s heel. This results in a total serum bilirubin (TSB) level. If the level is high, based upon the baby’s age in hours and other risk factors, treatment will likely follow. Repeat blood samples will also likely be taken to ensure that the TSB decreases with the prescribed treatment.

Treatment

No baby should develop brain damage from untreated jaundice.

When being treated for high bilirubin levels, the baby will be undressed and put under special lights. The lights will not hurt the baby. This can be done in the hospital or even at home. The baby’s milk intake may also need to be increased. In some cases, if the baby has very high bilirubin levels, the doctor will do a blood exchange transfusion. Jaundice is generally treated before brain damage is a concern.

Putting the baby in sunlight is not recommended as a safe way of treating jaundice.

Risk Factors

About 60% of all babies have jaundice. Some babies are more likely to have severe jaundice and higher bilirubin levels than others. Babies with any of the following risk factors need close monitoring and early jaundice manage­ment:

Preterm Babies

Babies born before 37 weeks, or 8.5 months, of pregnancy might have jaundice because their liver is not fully developed. The young liver might not be able to get rid of so much bilirubin.

Babies with Darker Skin Color

Jaundice may be missed or not recognized in a baby with darker skin color. Checking the gums and inner lips may detect jaundice. If there is any doubt, a bilirubin test should be done.

East Asian or Mediterranean Descent

A baby born to an East Asian or Mediterranean family is at a higher risk of becoming jaundiced. Also, some families inherit conditions (such as G6PD deficiency), and their babies are more likely to get jaundice.

Feeding Difficulties

A baby who is not eating, wetting, or stooling well in the first few days of life is more likely to get jaundice.

Sibling with Jaundice

A baby with a sister or brother that had jaundice is more likely to develop jaundice.

Bruising

A baby with bruises at birth is more likely to get jaundice. A bruise forms when blood leaks out of a blood vessel and causes the skin to look black and blue. The healing of large bruises can cause high levels of bilirubin and your baby might get jaundice.

Blood Type

Women with an O blood type or Rh negative blood factor might have babies with higher bilirubin levels. A mother with Rh incompatibility should be given Rhogam.

• When severe jaundice goes untreated for too long, it can cause brain damage and a condition called kernicterus.
• Early diagnosis and treatment of jaundice can prevent kernicterus.
• If you’re concerned that your baby might have jaundice visit your baby’s doctor right away. Ask for a jaundice bilirubin test.

If You’re Concerned

If you think your baby has jaundice you should call and visit your baby’s doctor right away. Ask your baby’s doctor or nurse about a jaundice bilirubin test.

If your baby does have jaundice, it is important to take jaundice seriously and stick to the follow-up plan for appointments and recommended care.

Make sure your baby is getting enough to eat. The process of removing waste also removes bilirubin in your baby’s blood. If you are breastfeeding, you should nurse the baby at least 8 to 12 times a day for the first few days. This will help you make enough milk for the baby and will help keep the baby’s bilirubin level down. Support and advice for breastfeeding mothers may increase the chances of successful breastfeeding. If you are having trouble breastfeeding, ask your doctor, nurse, or a lactation coach for help.

Newborn jaundice

Newborn jaundice is when your baby’s skin and the white parts of his eyes look yellow. It’s caused by the build-up of a substance in the blood called bilirubin. Newborn jaundice is very common—about 3 in 5 babies (60 percent) have jaundice.

Jaundice usually happens a few days after birth. Most of the time, it’s mild, doesn’t hurt your baby and goes away without treatment. But if a baby has severe jaundice and doesn’t get quick treatment, it can lead to brain damage.

What causes jaundice in newborns?

Your baby’s body recycles some red blood cells each day. Bilirubin is a yellow substance that forms as red blood cells break down. During pregnancy, your liver removes bilirubin for your baby. After birth, your baby’s liver may not be developed enough to properly remove bilirubin on its own. It can take a few days for your baby’s liver to be able to do this.

When a baby’s liver causes jaundice in the first days of life, it’s called physiologic jaundice. This is the most common kind of jaundice in newborns. But sometimes a health condition in your baby can cause jaundice. Babies with these health conditions are more likely to need treatment to help lower their bilirubin levels than babies with physiologic jaundice. These conditions include:

• Blood type mismatches, like Rh disease. A small number of babies have different blood types than their mothers. These mismatches can lead to a faster breakdown of red blood cells.
• Internal bleeding. This is bleeding inside the body. 
• A problem with your baby’s liver. Your baby’s liver may not work well if he has an infection, like hepatitis, or a disease, like cystic fibrosis, that affects the liver. 
• A problem with your baby’s red blood cells. Some babies have too many red blood cells. This is more common in some twins and babies who are small for gestational age. This means a baby who is smaller than normal based on the number of weeks he’s been in the womb. 
• A genetic condition, like G6PD deficiency. This condition is when your body doesn’t have enough G6PD, an enzyme that helps your red blood cells work the right way. 
• An infection, like sepsis. This is an infection in your baby’s blood. 
• Bruising at birth. A bruise happens when blood leaks out of a blood vessel. Sometimes babies get bruises during labor and birth. When large bruises heal, bilirubin levels may rise. 

Some babies are more likely than others to have jaundice. These include:

• Premature babies. A premature baby is one who is born too early, before 37 weeks of pregnancy. A premature baby is more likely than others to have jaundice because his liver may not be fully developed.
• Breastfed babies, especially babies who aren’t breastfeeding well. If you’re breastfeeding, feed your baby when he’s hungry. For most newborns, this is once every 2 to 3 hours (about eight to 12 times each day). Feeding this often helps keep your baby’s bilirubin level down. If you’re having trouble breastfeeding, ask your baby’s provider, a nurse or a lactation consultant for help. A lactation consultant is a person with special training in helping women breastfeed. 
• Babies with East Asian or Mediterranean ethnic backgrounds. Ethnic background means the part of the world or the ethnic group your ancestors come from. An ethnic group is a group of people, often from the same country, who share language or culture. Ancestors are family members who lived long ago, even before your grandparents. 

How do you know if your baby has jaundice?

When a baby has jaundice, a yellowish color usually first appears on his face. It then may spread to his chest, belly, arms, legs and white parts of his eyes. The best way to see jaundice is in good light, like in daylight or under fluorescent lights. Jaundice can be harder to see in babies with darker skin.

Call your baby’s health care provider right away if your baby:

• Looks very yellow, orange or greenish-yellow
• Is hard to wake up or won’t sleep at all
• Has trouble breastfeeding or sucking from a bottle
• Is very fussy
• Has too few wet or dirty diapers 

Call 911 or take your baby to the hospital if he:

• Won’t stop crying or has a high-pitched cry
• Arches backward
• Has a stiff, limp or floppy body
• Has strange eye movements 

These may be warning signs of dangerously high levels of bilirubin that need quick treatment to prevent kernicterus. This is a kind of brain damage caused by high bilirubin levels. Kernicterus isn’t common because babies usually are treated before jaundice becomes severe. If untreated, kernicterus can cause:

• Athetoid cerebral palsy. Babies with this condition have uncontrollable movements in the arms, legs, face and other body parts.
• Hearing loss
• Vision problems
• Dental problems 
• Intellectual disabilities 

How are babies checked for jaundice?

The American Academy of Pediatrics (AAP) recommends that all babies be checked for jaundice after birth while in the hospital. Your baby’s provider checks her with one or more of these tests:

• Blood test. This is the best way to measure bilirubin levels. Your baby’s provider takes a small sample of blood from her heel to do this test.
• Physical exam. Your baby’s provider checks your baby’s body for signs of jaundice. 
• Skin test. Your baby’s provider places a device on your baby’s forehead to check her bilirubin level. The device measures the reflection of a special light that shines through her skin.

The AAP recommends that babies be checked for jaundice again at 3 to 5 days of age. This is the time when bilirubin levels are the highest. If your baby leaves the hospital before 72 hours (3 days) of age, she should be checked within the next 2 days.

How is jaundice treated?

Most babies with jaundice don’t need treatment. If your baby has mild jaundice, her provider may recommend that you breastfeed your baby more often so that she has more bowel movements. This helps to get rid of bilirubin.

Jaundice usually clears up within 2 weeks in formula-fed babies. It may last for more than 2 to 3 weeks in breastfed babies. If your baby’s jaundice lasts more than 3 weeks, talk to his health care provider.

If your baby has more severe jaundice, she may need treatment including:

• Phototherapy treatment (also called light therapy or bili lights). This is when your baby is placed under special lights that help her body change bilirubin into a form that she can get rid of in her urine. While she is under the lights, your baby wears just a diaper and shields over her eyes. Some babies can lie on a light therapy blanket (also called a fiber optic blanket) that has tiny bright lights in it. You may use the blanket in place of, or along with, the overhead lights. Phototherapy can be done in the hospital or at home, and it’s safe for your baby.
• Exchange transfusion. If phototherapy doesn’t work and your baby’s bilirubin levels are still very high, she may need a special type of blood transfusion called an exchange transfusion. An exchange transfusion gets rid of bilirubin by replacing your baby’s blood with fresh blood in small amounts.
• Intravenous immunoglobulin (also called IVIg). If you and your baby have different blood types, your baby may get immunoglobulin (a blood protein) through a needle into a vein. This can help her treat her jaundice so that she’s less likely to need an exchange transfusion.

See also: Premature babies

Last reviewed: April, 2013
90,000 Jaundice in newborns

It happens that on the second or third day after birth, the child turns yellow. This is not a pathology, it is a natural process that occurs due to the infant’s adaptation to environmental conditions. And it is called physiological jaundice. Let’s see what jaundice is and how it develops.

Jaundice is a symptom, not a disease. And you need to treat not him, but the cause that caused the condition.

In human blood, there are red blood cells – erythrocytes, designed to carry oxygen and carbon dioxide in the body.The period of their existence is 120 days, after which they die. Thus, every day 1% of the total pool of red blood cells is destroyed. In the process of destruction, metabolic products are released into the blood. One of them is the pigment bilirubin, which gives the skin its yellow color. Bilirubin is toxic to the body, so it detoxifies and removes it with the help of the liver. In it, liver enzymes neutralize, and the pigment is excreted by the intestines. If this process is disrupted, the level of bilirubin rises, which is manifested by jaundice.

Physiological jaundice of newborns

And now about a specific condition – jaundice in newborns. It is not dangerous. Immediately after birth, a large amount of fetal hemoglobin breaks down in the baby’s body, as a result of which a lot of bilirubin is released into the blood. And in the liver the liver enzymes necessary to neutralize bilirubin have not yet matured. Therefore, 50-60% of newborns develop physiological jaundice 2-3 days after birth.It takes time for the liver to learn how to neutralize and excrete bilirubin. The likelihood of development is higher in premature babies and is 80-90%. And that’s okay.

• How do I know if my child has physiological jaundice? Not dangerous jaundice?

Only a doctor can accurately determine the cause of jaundice and the degree of danger. However, it is worth knowing that with physiological jaundice, the yellowness of the sclera, skin and mucous membranes is not accompanied by other symptoms.For jaundice caused by other causes, the baby does not feel well, cries, eats poorly, and does not gain weight.

• Can I be vaccinated against hepatitis B with physiological jaundice?

Neonatal jaundice does not appear to be a contraindication for hepatitis B and other vaccinations.

• Does physiological jaundice affect the child’s condition in the future?

No, jaundice of newborns does not affect the health of the child in any way.

Features of the treatment of neonatal jaundice

In most cases, jaundice resolves in 2 to 3 weeks. Complications of such jaundice are extremely rare, however, an excessive increase in bilirubin (especially indirect) is dangerous with toxic effects, and the lack of appropriate treatment can lead to adverse consequences.

The doctor takes into account all the accompanying factors in order to plan the frequency of examinations and find out the risk of an increase in bilirubin:

• current bilirubin content;
• the presence of prematurity;
• activity and appetite of the child;
• mother’s lactation level;
• a hereditary predisposition to severe jaundice.

Treatment that lowers the level of bilirubin in the blood can be as follows.

• Phototherapy. The child is placed under special lamps with high intensity blue-green light. Such light has the ability to transform the structure and shape of indirect hemoglobin so that it becomes water-soluble, sufficient for its utilization in urine and feces. This procedure is harmless, as the ultraviolet spectrum is blocked by a special filter and does not get on the baby’s skin.
• Intravenous injection of immunoglobulin. If the cause of jaundice is the incompatibility of the blood of the mother and the child, intravenous immunoglobulin can be used. This will help lower your antibody levels. This may be enough.
• Blood transfusion. It is used to rapidly lower bilirubin and is performed in the intensive care unit. A certain amount of blood is taken from a child with a high level of bilirubin, and donor blood with normal levels is injected at the same time.Thus, bilirubinemia decreases and hemoglobin is normalized.
• Plasmapheresis. This method is applicable in complex medical cases. Repeated sampling of small volumes of blood from a child is performed, they are cleaned of plasma with a high level of bilirubin and antibodies, diluted with saline or donor plasma and injected back intravenously. Like transfusion, plasmapheresis is very effective. However, both methods are used in extreme cases, for example, when hemolytic disease is present.
• If jaundice is not severe, some dietary changes can be dispensed with. More frequent feedings stimulate the bowel movement, so that bilirubin is excreted more actively.

Remember that only a doctor can determine whether jaundice in a newborn is a pathology or a norm. In any suspicious cases, sign up for a consultation with a pediatrician!

Jaundice – ProMedicine Ufa

Jaundice is more likely not a disease, but a symptom that clearly indicates liver damage, as well as some blood diseases.In case of jaundice, bilirubin accumulates in excess in the blood and is not excreted in the usual way, which leads to yellowing of the skin and sclera. Jaundice is not isolated as an independent disease. Doctors perceive yellowing of the sclera and skin as a dangerous signal, which is always a reason for high-quality diagnostics.

The reason for the yellowness of the skin is a yellow pigment, which is a breakdown product of hemoglobin. In a healthy person, bilirubin is successfully excreted from the body through the digestive tract along with feces.If a person suffers from liver failure and obstruction of the biliary tract, bilirubin begins to accumulate in the blood. Its excess is partially excreted through the kidneys, creating an excessive load on them, as well as through the skin, which causes its yellowness.

Causes and Symptoms

The causes of jaundice are disruption of the liver and biliary tract. Also, the cause of the disease can be an infection, and first of all, hepatitis. The most common cause of jaundice is hepatitis A, which is also the most easily transmitted disease.

Infection occurs through water, food, unwashed hands. In general, it will be quite enough simple contact with an infected person to get hepatitis A. Much more serious pathogens of hepatitis B, C are transmitted only through blood, and this can be doctor’s negligence or unprotected sex.

The symptoms of jaundice are fairly easy to recognize. The disease is always accompanied by pain in the right hypochondrium, where the liver is located. Also, jaundice is often accompanied by chills, fever, headache.A sick person begins to lose weight, there is an upset digestion, loss of appetite.

If cholecystitis is the cause of jaundice, biliary eructation may also occur. Jaundice is characterized by general symptoms of intoxication of the body (nausea, muscle pain, and so on).

Diagnosis and treatment of jaundice

For an accurate diagnosis, the doctor prescribes a general and biochemical blood test, tests for bilirubin in the blood are required, and liver function tests are also carried out.Sometimes a liver biopsy is done, the results of which allow the doctor to conclude about the nature of the disease and the severity of the liver damage.

Depending on what caused the jaundice, the doctor prescribes drug therapy aimed at destroying the excess bilirubin in the blood. Often, jaundice is treated with phototherapy, since bilirubin is effectively degraded by ultraviolet radiation. Jaundice in newborns is not treated with drugs. Usually, in young children, liver function is restored on its own, and physiological jaundice disappears after a while without a trace.

It is also important to follow the correct diet: the diet for jaundice should be soft and gentle for the liver and gallbladder. It is good to eat low-fat dairy products, vegetable dishes, lean fish and meat. It is not recommended to eat vegetables containing coarse crude fiber during the period of illness.

Prevention

The first and foremost protective measure in prevention is the simplest personal hygiene. Attention to your own purity, this is the way to prevent jaundice.

Particular attention should be paid to the cleanliness of food, fruits and vegetables must be thoroughly washed. Always wash your hands before eating, and try to drink only boiled water if possible. These measures will already halve the rice getting jaundice.

It is possible to include in preventive measures simple disinfectants, with which to wipe hands, personal and public items, pens, staplers, pencils in everyday life.

In addition to household forms of prophylaxis, it makes sense to turn to medical forms and get several vaccinations.Science does not stand still, and new vaccinations are constantly emerging that protect us from all three types of hepatitis. Moreover, this vaccine can work throughout life.

Jaundice of a Healthy Newborn: Causes, Course, Forecast | Goryainova

1. Nelson Textbook of Pediatrics, 20th Edition. Edited by Kliegman RM, Stanton BF, St Geme JW, Schor NF. 2016.3474 p.

2.Memon N, Weinberger BI, Hegyi T and Aleksunes LM. Inherited Disorders of Bilirubin Clearance. Pediatr Res, 2016 March, 79 (3): 378-386. doi: 10.1038 / pr.2015.247.

3. Onishi S, Kawade N, Itoh S et al. Postnatal development of uridine diphosphate glucuronyltransferase activity towards bilirubin and 2-aminophenol in human liver. Biochem J 1979, 184: 705-7.

4.Maisels MJ. Chapter in effective care of the newborn infant. In: Sinclair JC, Bracken MA, editors. Oxford, UK: Oxford Medical Publications, 1992: 507–61.

5. Maisels MJ, Gifford K, Antle CE, Leib GR. Jaundice in the Healthy Newborn Infant: A New Approach to an Old Problem. Pediatrics 1988 Apr 81 (4): 505-11.

6. Fujiwara R, Maruo Y, Chen S, Tukey RH.Role of extrahepatic UDP-glucuronosyltransferase 1A1: Advances in understanding breast milk-induced neonatal hyperbilirubinemia. Toxicol Appl Pharmacol 2015 Nov 15, 289 (1): 124-132.

7. Sherlock Sh., Dooley J. Diseases of the liver and biliary tract. Per from English. M .: GEOTAR, 1999.860 p.

8. Newman AJ and Gross S. Hyperbilirubinemia in breast-fed infants.Pediatrics, 1963, 32: 995.

9. Arias IM, Gartner LM, Seifter S and Furman M. Prolonged Neonatal Unconjugated Hyperbilirubinemia Associated with Breast Feeding and a Steroid, Pregnane-3 (Alpha), 20 (Beta) -Diol, in Maternal Milk That Inhibits Glucuronide Formation In Vitro … Journal of Clinical Investigation, 1964, 43 (11): 2037-2047.

10.Gartner LM. Breastfeeding and Jaundice. J Perinatol, 2001 Dec, 21 (Suppl 1): S25-29, discussion S35-39.

11. Maruo Y, Morioka Y, Fujito H et al. Bilirubin Uridine Diphosphate-Glucuronosyltransferase Variation Is a Genetic Basis of Breast Milk Jaundice. J Pediatr, 2014 July, 165 (1): 36-41.e1. doi: 10.1016 / j.jpeds.2014.01.060.

12.Lucey J, Ferreiro M, Hewitt J. Prevention of hyperbilirubinemia of prematurity by phototherapy. Pediatrics, 1968, 41: 1047.

90,000 “Jaundice” of newborns. Calm, only calm

Mom. You have a baby. Look at him. He is your little copy. But still, in order to become an adult, he needs to change, go a long and difficult way, adapt to an independent life. Therefore, in the neonatal period, so-called “transitional states” are frequent, characteristic only for these children.One of the most famous of these conditions is neonatal jaundice. We, neonatologists, call it affectionately – “jaundice”.

It has nothing to do with infectious jaundice – hepatitis. Jaundice in newborns is physiological and pathological. Physiological jaundice disappears without a trace within a short period of time. Pathological jaundice of newborns is caused by diseases and often requires close medical supervision. And yet, the most common jaundice in children who have just been born is physiological.

It occurs in about 60-70% of babies and appears 3-4 days after birth. This condition is not a disease, it goes away over time. It is associated with the immaturity of some systems of the child’s body responsible for the exchange of a special substance – bilirubin. With physiological jaundice, the general condition of children, as a rule, does not suffer. It is very quick and easy to heal. Now more and more specialists and clinics around the world refuse to use special drugs for the treatment of jaundice in newborns.

To date, the most effective and proven method of reducing the toxicity of bilirubin in physiological jaundice is proper breastfeeding, which allows the child to “heal himself”. The best prevention and treatment of physiological jaundice is early and frequent feedings. If necessary, the specialists of the Clinical Maternity Hospital carry out “phototherapy” for their little patients. It is completely safe for the child.

Special recommendations for observation in the clinic in such cases are not required.From the mother, only love, affection and proper feeding with the most useful breast milk are needed.

S. V. Lapeko – Head of the observational department of newborns
GBUZ JSC “Clinical Maternity Hospital”

90,000 Phototherapy for newborns

Use of phototherapy for newborns

From the moment of its birth, the child’s body begins to adapt to new environmental conditions. One of the main adaptive mechanisms of the newborn is the manifestation of signs of physiological jaundice.While the baby is in the womb, his blood contains many more red blood cells than the blood of an adult. This phenomenon is due to the fact that the fetus receives oxygen by transporting it from the mother’s blood through the umbilical cord. And for an acceptable level of saturation of the cells and tissues of the fetus, a lot of hemoglobin is needed, which is part of the erythrocytes. From the moment the child switched to pulmonary respiration (the moment of birth), his body ceases to need such a large number of red blood cells, they begin to break down and, as a result, release fetal hemoglobin, which destroys and releases bilirubin from the body.A large amount of free bilirubin also causes a yellow staining of the mucous membranes and skin of the newborn. In most cases, such a phenomenon as physiological jaundice begins to manifest itself on the third or fourth day of the child’s life and disappears without a trace after 14-21 days.

Bilirubin is a toxic substance. The body tries to get rid of it by binding it to a special protein – albumin. However, if the amount of bilirubin is much higher than albumin, then it begins to negatively affect the central nervous system of the child, provoking the development of the so-called “nuclear jaundice”.In addition to physiological jaundice, which, in principle, is the norm, there are also its pathological forms: hereditary conjugational jaundice, hemolytic disease of newborns, infectious-toxic hepatic jaundice. All of these conditions require targeted therapy, the goal of which is to reduce the toxicity of bilirubin. Today, one of the most effective ways to achieve this is through the use of phototherapy. Consider the questions about what kind of method it is, what indications it has, what possible side effects it can cause.

What is phototherapy?

Phototherapy refers to one of the physiotherapy procedures, which is based on the therapeutic effect of the ultraviolet spectrum of sunlight with a wavelength in the range from 400 to 550 nm on the human body. A light wave of the right length transforms excess bilirubin into an isomer. The body of a newborn is able to naturally excrete the obtained isomer without difficulty (urine and feces), as a result of which the level of bilirubin in his blood decreases and the body as a whole receives protection from negative toxic effects.

Today, among the many phototherapy systems, the Photo-Therapy 4000 phototherapy lamp for newborns stands out for a number of advantages:

• A new approach to phototherapy. Due to its high reliability and low cost, Photo-Therapy 4000 is recommended as a highly effective solution for the treatment of hyperbilirubinemia in newborns.
• Economical and efficient phototherapy. The blue part of the spectrum, with an absorption peak of 460 nm, is especially effective for converting bilirubin.Drager blue fluorescent lamps emit light in this particular spectrum range and are therefore ideal for this type of therapy.
• Balanced therapy to combat hyperbilirubinemia. The PT4000 delivers high intensity light output with the most effective wavelength and covers a large area around the crib.
• Compact dimensions. Lightweight, quiet and compact make it ideal for pediatric wards, neonatal intensive care units and pediatric wards.
• The Photo-Therapy 4000 uses 2 white light lamps (for illumination) and 4 blue light phototherapy lamps. Both types of lamps can be switched on independently of each other. The radiation power at a distance of 30 cm is 43 μW / cm2 / nm. The lamp is equipped with a liquid crystal display – a time counter that displays the total operating time of the device, which allows you to monitor the life of phototherapy lamps (blue light) for their timely replacement. The manufacturer recommends replacing these lamps after 1000 hours of use.
• The phototherapy lamp can be used on a mobile stand, or can be placed directly on the incubator shed.
• The mobile stand is equipped with four wheels, each with a brake lock.

How is phototherapy performed?

A completely undressed newborn is placed in a special incubator, for protection from harmful ultraviolet radiation, the child’s eyes are covered with special glasses. Boys are additionally covered with dark tissue on the genitals.An ultraviolet lamp is installed at a distance of about half a meter from the newborn. Interestingly, it is most effective to use not one UV lamp, but a combination of four UV and two fluorescent lamps. The child “warms up” under the light for as long as the doctor says. The first improvements are visually noticeable as early as the tenth hour of therapy. The maximum break in phototherapy can last no longer than four hours in a row. In some, especially severe cases, phototherapy is carried out without interruption.The average course of treatment is approximately 96 hours.

Every 60 minutes a newborn is in the incubator, the position of his body should be changed – turned from back to stomach and back, put on his side. To exclude the possibility of overheating the child, it is necessary to measure his body temperature every two hours using an electronic or mercury thermometer.

An important point: during the period of phototherapy, the volume of fluid necessary for the child should be increased by 15-20% of the normal physiological need.

Throughout the course of phototherapy treatment, it is necessary to take the child’s blood every day for its analysis of biochemistry. If there is a threat of encephalopathy development, then the blood should be checked at least three times a day. A biochemical blood test is the only method to assess the effectiveness of phototherapy.

Indications for treatment

The following conditions are considered indications for phototherapy in newborns:

• High risk of developing hyperbilirubinemia in the fetus, which was identified during the period of its intrauterine development.
• Insufficient morphological and functional maturity of the child.
• Extensive hemorrhages and hematomas on the body.
• High risk of a hereditary form of hemolytic anemia.
• Physiological jaundice of the newborn.
• Hemolytic disease of the newborn, provoked by incompatibility in blood group (phototherapy in this situation is the main method of therapy).
• Hemolytic disease of the newborn, provoked by Rh-conflict (as an additional treatment after blood transfusion as a way to prevent a re-increase in the level of bilirubin).
• Preparation for blood transfusion and rehabilitation period after surgery.
• Increase in the level of bilirubin more than 5 μmol / L per hour – for babies born at term, and more than 4 μmol / L per hour for babies born prematurely.

Indications for newborns during the first seven days of life, depending on body weight and bilirubin level:

• body weight less than 1.5 kg, bilirubin level 85-140 μmol / l;
• body weight up to 2 kg, bilirubin level 140-200 μmol / l;
• body weight up to 2.5 kg, bilirubin level 190-240 μmol / l;
• body weight over 2.5 kg, bilirubin level 255–295 µmol / l.

In addition to the indications listed above, the risk of developing bilirubin encephalopathy should be adequately assessed:

• Assessment on the Apgar scale at the fifth minute after birth – 4 points.
• Rapid development of anemia.
• Rapid deterioration of the general condition of the newborn on the background of hyperbilirubinemia.
• Critically low concentration of albumin protein in blood plasma (no more than 25 g / l).
• The partial pressure of oxygen is less than 40 mmHg. Art.
• The acidity of arterial blood is less than 7.15 for more than 1 hour.
• Low rectal temperature (not higher than 35 C).

When do you stop phototherapy?

Treatment is stopped only on condition that the biochemical analysis of the newborn’s blood shows a stable decrease in total bilirubin and a non-increase in free bilirubin. If these conditions are met, then phototherapy can be completed without any concern for the health of the child.

Are there side effects?

Side effects during phototherapy do not have any negative effect on the general condition of the newborn, but they do occur:

• Peeling and dryness of the skin.
• Increased sleepiness – children spend almost the entire course of treatment under the lamps in their sleep.
• Frequent stools.
• The skin of the newborn takes on a bronze tint (which looks like a tan).

All these changes do not imply treatment with medications, they disappear without a trace a couple of days after the completion of the course of phototherapy.

When is phototherapy prohibited?

Despite all the benefits and harmlessness of phototherapy, this method of treatment has a number of contraindications, including those identified in a newborn:

• High level of bound bilirubin in the blood.
• Pathological disorders in the liver.
• Diagnosed obstructive jaundice.

According to neonatological statistics, more than 70% of newborns in one way or another experience physiological jaundice. Parents should not be afraid of this phenomenon, they just need to follow the instructions of the doctor. Some mothers find UV radiation harmful to their baby and refuse treatment. In no case should this be done, because if the level of free bilirubin is not artificially reduced, then the newborn’s body will suffer from toxic poisoning and, most likely, will not be able to cope with this condition on its own, complications of jaundice will arise, up to the strongest damage to the central nervous system and liver failure.You should take a responsible approach to the new role of a parent from the very first minutes of your child’s life!

Photo-Therapy 4000 blue and white light bulbs for newborns

90,000 “Jaundice” of newborns. Calm, only calm.

Mom. You have a baby. Look at him. He is your little copy. But still, in order to become an adult, he needs to change, go a long and difficult way, adapt to an independent life.Therefore, in the neonatal period, the so-called “transitional states”, characteristic only for these children. One of the most well-known of these conditions is neonatal jaundice. We, neonatologists, call it affectionately – “jaundice”. Because it has nothing to do with infectious jaundice – hepatitis.

Jaundice in newborns is physiological and pathological. Physiological jaundice disappears without a trace within a short period of time.Pathological jaundice of newborns is caused by diseases and often requires close medical supervision.

Yet the most common jaundice in newly born babies is physiological . It occurs in about 60-70% of babies and appears 3-4 days after birth. This condition is not a disease and will pass over time. It is associated with the immaturity of some systems of the child’s body responsible for the exchange of a special substance – bilirubin.With physiological jaundice, the general condition of children, as a rule, does not suffer. It is very quick and easy to heal.

Now more and more specialists and clinics around the world are abandoning the use of special drugs for the treatment of neonatal jaundice. To date, the most effective and proven method of reducing the toxicity of bilirubin in physiological jaundice is proper breastfeeding, which allows the child to “heal himself.”The best prevention and treatment of physiological jaundice is early and frequent feedings.

If necessary, the specialists of the Clinical Maternity Hospital provide “phototherapy” for their little patients. It is completely safe for the child.

Special recommendations for observation in the polyclinic in such cases are not required. From the mother, only love, affection and proper feeding are needed, the most useful – breast milk.

Good luck to you and your children!

S.V. Lapeko – head of the observational department of newborns, GBUZ JSC “Clinical Maternity Hospital”

Infant jaundice | Clinic Kind Doctor

Infant jaundice or neonatal jaundice occurs in almost every newborn baby, especially premature babies.

Why does the skin turn yellow?

This occurs during the breakdown of red blood cells, when a large amount of bilirubin is formed, a yellow pigment that is excreted by the liver.The enzyme system of the newborn is not yet perfect, so there is an accumulation of bile pigment in the skin and visible mucous membranes (sclera of the eyes). There is not enough enzyme glucuronyltransferase to bind bilirubin and remove it from the body. With the establishment of the enzyme system of the liver, the fading of yellowness begins on the 10-14th day.

An increase in bilirubin over 80-90 µmol / l in a full-term and more than 120 µmol / l in a premature newborn is already manifested by yellowness of the skin and mucous membranes.

Neonatal jaundice is divided into physiological and pathological.

With physiological jaundice, or, in other words, transient jaundice of the skin appears on 3-5 days and fades away after 10-14 days. In this case, the total bilirubin is increased due to indirect bilirubin. The general condition of the baby does not suffer, he gains weight. With this jaundice, there are no contraindications for vaccination in the maternity hospital. The child does not need treatment.

In pathological jaundice, yellowness of the skin, mucous membranes can appear as early as 1 day or after 2 weeks of life and has an undulating course.The stool may become discolored (discolored) and the urine may become dark. In addition to an increase in bilirubin, anemia appears. When examining the abdominal cavity, an increase in the liver and spleen is noted, and in severe cases, nuclear jaundice, bilirubin encephalopathy, that is, brain damage, in other words, intoxication with bilirubin of almost the whole body can develop.

Therefore, with high bilirubin (above 256 μmol / l in a full-term and 171 μmol / l in a premature newborn), if the doctor of the pediatric department is born.at home – the neonatologist says that you need to be hospitalized, so you need to listen. Since in stationary conditions, the exact cause of the increase in bilirubin will be established and appropriate treatment will be carried out.

If the yellowness of the skin persists for more than 3-4 weeks, it is imperative to consult a doctor to clarify the diagnosis, even if you were told at the patronage that it is physiological jaundice. It is up to the doctor to decide what kind of jaundice the child has and why it is lingering.

If all the same you are told that the jaundice is physiological, but the bilirubin figures are high, BUT not critical, then you can use the currently effective method of treatment – phototherapy.

Phototherapy is a treatment with a blue quartz lamp. This treatment is started in the maternity home and after 2-3 sessions you yourself will notice that your baby’s skin brightens and jaundice decreases.

It is also recommended to give during this period the usual boiled water of 5-10 ml between feedings and often apply to the breast.

After being discharged from the maternity home, it is recommended to continue treatment – walking in sunny weather, putting the baby near the window also in sunny weather, as if they had put the baby to “sunbathe”.

Prevention of infant jaundice consists in timely examination during pregnancy, when it is possible to predict the Rh conflict for the Rh factor or blood group during pregnancy and after childbirth, that is, the development of pathological jaundice, the so-called hemolytic disease of the newborn.